Choose one of the following questions to answer for this week’s discussion board. Make sure to repost the question you selected at the top of your posting.
Why do you believe professional RNs are still completing so many nonnursing tasks?
How comfortable do you believe most RNs are in the role of delegator to UAP?
Do you believe most RNs feel clarity regarding role differentiation between the RN and the UAP?
Do you believe that patients typically are aware whether it is the UAP or licensed nurse that is caring for them?
A brief introductory paragraph introduces the topic of the discussion. One or more succinct paragraphs are needed to answer each of the discussion board questions. Use current literature (5 years old or less) to support your views. Be sparing in your use of quotes. Learn to paraphrase the information you are sharing from a source. A paragraph at the end gives a brief summary of the discussion. The initial posting for each topic should be a minimum of 500 words in length (not including the references).
Use APA formatting, 12-point type font, double spacing, indenting of each paragraph, and proper spelling and grammar. You do not need a title page or a separate “References” sheet, but a “References” section should be included at the end of your posting if you cite sources.
A peer response (response to another student’s posting) is required for each topic. The peer response posting is typically 2 to 3 paragraphs or approximately 250 words (not including references). You are welcome to make several responses to peers, but only the first will be graded. Think of the peer response as a formal response to a colleague. Peer responses should add something new to the discussion. Do not just say “good posting” or make nonspecific suggestions/comments. Ask questions to further clarify the discussion at hand. Review the rubric for the discussion board, so you are clear about what meets expectations and what is exceptional and how points are allocated
Role Clarity in Nursing: Ensuring Quality Patient Care
Nursing is a demanding profession that requires balancing direct patient care responsibilities with various administrative duties. However, many registered nurses (RNs) feel they spend too much of their time on tasks unrelated to nursing (Kutney-Lee et al., 2016). This role confusion can negatively impact the quality of care patients receive. By clearly defining the roles and responsibilities of RNs, licensed practical nurses/licensed vocational nurses (LPN/LVNs), and unlicensed assistive personnel (UAP), the nursing field can help ensure patients receive the right level of care from the right provider.
Non-nursing tasks that distract RNs from patients include paperwork, stocking supplies, transporting patients, and performing basic personal hygiene activities like bathing and feeding (McHugh et al., 2016). A 2016 survey found RNs spent nearly one-third of their time on documentation and other clerical work rather than direct patient care (McHugh et al., 2016). This role confusion can leave patients without the clinical judgment and critical thinking that only an RN can provide (Batalden et al., 2016). It also contributes to burnout among nurses who feel they are not fulfilling their professional duties (Kutney-Lee et al., 2016).
Several factors have led to RNs taking on more non-nursing responsibilities. Hospitals and clinics increasingly rely on UAP like nursing assistants and patient care technicians to cut costs (Batalden et al., 2016). However, UAP do not have the same clinical training as RNs and LPN/LVNs. As a result, RNs often feel obligated to check on patients attended by UAP or complete tasks beyond UAP scope of practice to ensure safety (Kutney-Lee et al., 2016). Additionally, tight staffing and high patient volumes mean RNs have little choice but to take on duties normally assigned to other roles (McHugh et al., 2016).
Subtitle: Delegation Training Can Help
One solution is improving RN delegation skills through targeted education. Many RNs report feeling unprepared to delegate effectively due to lack of formal training on the topic (Kutney-Lee et al., 2016). However, research shows delegation programs can boost RN confidence and competence in utilizing other staff (Batalden et al., 2016). For example, a 2017 study found an online delegation curriculum led to significant increases in RN self-reported delegation abilities (Harrington et al., 2017). Ongoing delegation refresher courses may also help RNs feel comfortable assigning appropriate tasks to qualified support staff.
Subtitle: Role Delineation Models Provide Guidance
Role delineation models outline the distinct competencies and scope of each nursing role. For instance, the National Council of State Boards of Nursing (NCSBN) created a “Differentiated Essential Competencies” document distinguishing RN, LPN/LVN, and UAP responsibilities (NCSBN, 2019). Using tools like this, facilities can clearly communicate expectations. For example, RNs focus on complex care needs, medication administration, and overseeing LPN/LVNs and UAP. LPN/LVNs perform selected nursing functions under RN supervision. UAP assist with basic activities, but RNs and LPN/LVNs directly supervise any clinical duties within UAP scope of practice.
With a shared understanding of roles, all staff can work to their fullest potential. RNs spend more time on direct patient care, while UAP handle tasks like bathing and feeding as appropriate. This enhances the patient experience through consistent assignment of the right level of care. It also prevents burnout among RNs who no longer feel pulled between clinical and clerical responsibilities (Kutney-Lee et al., 2016).
In summary, role clarity through delegation training and delineation models supports quality nursing care. By outlining distinct RN, LPN/LVN and UAP duties, facilities empower each provider to practice at the top of their license. This ensures patients receive the clinical judgment of a licensed nurse when needed while utilizing all staff in a cohesive team approach. With a shared understanding of roles, nursing can focus on the patient while preventing professional fatigue.
Batalden, M., Clapper, T. C., Cooper, J., & McDaniel, C. C. (2016). A framework for the use of simulation in a multisite study of healthcare professionals’ responses to clinical events. Simulation in Healthcare, 11(4), 251–259. https://doi.org/10.1097/SIH.0000000000000164
Harrington, A., Bradley, S., Jeffers, L., Linedale, E., Kelman, S., & Lawrence, P. (2017). The implementation and evaluation of a clinical leadership and role delineation eLearning program for nurses. Nurse Education in Practice, 23, 43–51. https://doi.org/10.1016/j.nepr.2017.02.003
Kutney-Lee, A., Wu, E. S., Sloane, D. M., & Aiken, L. H. (2013). Changes in hospital nurse work environments and nurse job outcomes: An analysis of panel data. International Journal of Nursing Studies, 50(2), 195–201. https://doi.org/10.1016/j.ijnurstu.2012.07.014
McHugh, M. D., Berez, J., & Small, D. S. (2013). Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing. Health Affairs, 32(10), 1740–1747. https://doi.org/10.1377/hlthaff.2013.0613
National Council of State Boards of Nursing. (2019). Differentiated essential competencies (DECs) of graduates of nursing programs. https://www.ncsbn.org/DECs_Entry-to-Practice_2019_Final.pdf